Individual and socioeconomic consequences of obstructive sleep apnea syndrome

Main Article Content

Livia Cirluzo dos Santos Neto
Giuliana Angelucci Miranda
Laís Lourenção Garcia da Cunha
Bárbara Elza Silveira Canto
Victor Pires Strufaldi
Mauricio Faria Tetti
Marco Akerman
Leandro Luongo de Matos

Abstract

Obstructive Sleep Apnea Syndrome (OSAS) is defined as obstruction of air passage through the upper airways during sleep. The patient has repeated episodes of hypoxemia and hypercapnia, and because of those events, the sleep becomes superficial and fragmented, resulting in a series of complications for the individual and the community. The aim of the present study was to review the literature about individual, economic and social consequences caused by OSAS. Several complications of OSAS related to the individual were identified: (1) physical and behavioral changes: excessive sleeping, fatigue, anxiety, irritability, depression, decreased libido, decreased quality of life, metabolic (such as weight gain, diabetes and dyslipidemia) and cardiovascular consequences (such as hypertension, atherosclerosis and coronary heart disease); (2) neurocognitive impairment: deficits in attention, perception, memory, reasoning, opinion, thought and language. There are also some socio-economic repercussions related to OSAS, such as: (1) increased number, proportion and gravity of traffic accidents due to the decrease of driver’s concentration; (2) occupational injury with a fall in productivity, layoffs and workplace accidents; (3) social loss: the individual with OSAS is also a potential danger to society by increasing malpractice; (4) increased public and private expenditures: maintenance of highways and structure of supervision and support, social security spending, costs with diagnosis, therapies and hospital.  SAS should be considered a public health disease, given their unequivocal individual, social and economical damages. Specific policies should be implemented to reduce the impact of those consequences.

Downloads

Download data is not yet available.

Article Details

How to Cite
Santos Neto, L. C. dos, Miranda, G. A., Cunha, L. L. G. da, Canto, B. E. S., Strufaldi, V. P., Tetti, M. F., Akerman, M., & Matos, L. L. de. (2013). Individual and socioeconomic consequences of obstructive sleep apnea syndrome. ABCS Health Sciences, 38(1). https://doi.org/10.7322/abcshs.v38i1.6
Section
Review Articles
Author Biographies

Livia Cirluzo dos Santos Neto, Faculdade de Medicina do ABC

Disciplina de Saúde Coletiva da FMABC – Santo André (SP), Brasil.

Giuliana Angelucci Miranda, Faculdade de Medicina do ABC

Disciplina de Saúde Coletiva da FMABC – Santo André (SP), Brasil.

Laís Lourenção Garcia da Cunha, Faculdade de Medicina do ABC

Disciplina de Saúde Coletiva da FMABC – Santo André (SP), Brasil.

Bárbara Elza Silveira Canto, Faculdade de Medicina do ABC

Disciplina de Saúde Coletiva da FMABC – Santo André (SP), Brasil.

Victor Pires Strufaldi, Faculdade de Medicina do ABC

Disciplina de Saúde Coletiva da FMABC – Santo André (SP), Brasil.

Mauricio Faria Tetti, Faculdade de Medicina do ABC

Disciplina de Saúde Coletiva da FMABC – Santo André (SP), Brasil.

Marco Akerman, Faculdade de Medicina do ABC

Disciplina de Saúde Coletiva da FMABC – Santo André (SP), Brasil.

Leandro Luongo de Matos, Faculdade de Medicina do ABC

Disciplina de Saúde Coletiva da FMABC – Santo André (SP), Brasil.

References

Pandi-Perumal SR, Verster JC, Kayumov L, Lowe AD, Santana MG, Pires ML, et al. Sleep disorders, sleepiness and traffic safety: a public health menace. Braz J Med Biol Res. 2006;39(7):863-71. http://dx.doi.org/10.1590/S0100-879X2006000700003

Noal RB, Menezes AM, Canani SF, Siqueira FV. Ronco habitual e apneia obstrutiva observada em adultos: estudo de base populacional, Pelotas, RS. Rev Saúde Pública. 2008;42(2):224-33. http://dx.doi.org/10.1590/S0034-89102008000200006

Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-5. http://dx.doi.org/10.1056/NEJM199304293281704

Tufik S, Santos-Silva R, Taddei JA, Bittencourt LRA. Obstructive sleep apnea syndrome in the São Paulo epidemiologic sleep study. Sleep Med. 2010;11(5):441-6. http://dx.doi.org/10.1016/j.sleep.2009.10.005

Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365(9464):1046-53. http://dx.doi.org/10.1016/S0140-6736(05)71141-7

D'Ambrosio C, Bowman T, Mohsenin V. Quality of life in patients with obstructive sleep apnea. Chest. 1999;115(1):123-9. http://dx.doi.org/10.1378/chest.115.1.123

Balbani APS, Formigoni GGS. Ronco e síndrome da apneia obstrutiva do sono. Rev Assoc Med Bras. 1999;45(3):273-8. http://dx.doi.org/10.1590/S0104-42301999000300013

Barbé F, Pericás J, Mu-oz A, Findley L, Antó JM, Agustí AGN, et al. Automobile accidents in patients with sleep apnea syndrome. Am J Respir Crit Care Med. 1998;158(1):18-22. http://dx.doi.org/10.1164/ajrccm.158.1.9709135

Hanak V, Jacobson DJ, McGree ME, Sauver JL, Lieber MM, Olson EJ, et al. Snoring as a risk factor for sexual dysfunction in community men. J Sex Med. 2008;5(4):898-908. http://dx.doi.org/10.1111/j.1743-6109.2007.00706.x

Farias PAM. Distúrbios respiratórios do sono: avaliação das alterações do sono, sintomas depressivos e comorbidades. Tese [mestrado] – Programas de Pós-Graduação da CAPES em Ciências Farmacêuticas, Universidade Federal do Ceará, Fortaleza, 2006.

Zaharna M, Guilleminault C. Sleep, noise and health: review. Noise Health. 2010;12(47):64-9. http://dx.doi.org/10.4103/1463-1741.63205

Beninati W, Harris CD, Herold DL, Shepard Jr JW. The effect of snoring and obstructive sleep apnea on the sleep quality of bed partners. Mayo Clin Proc. 1999;74(10):955-8.

Stoppe Júnior A, Cordás TA. Depressão e ansiedade [internet]. Disponível em: http://www.moreirajr.com.br/revistas.asp?id_ materia=1871&fase=imprime. Acesso em 14 jun. 2011.

National Cholesterol Education Program. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-97. http://dx.doi.org/10.1001/jama.285.19.2486

Lam JC, Ip MS. Sleep & the metabolic syndrome. Indian J Med Res. 2010;131:206-16.

Vgontzas AN, Bixler EO, Chrousos GP. Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev. 2005;9(3):211-24. http://dx.doi.org/10.1016/j.smrv.2005.01.006

Carneiro G, Ribeiro Filho FF, Togeiro SM, Tufik S, Zanella MT. Interactions between obstructive sleep apnea syndrome and insulin resistance. Arq Bras Endocrinol Metabol. 2007;51(7):1035-40. http://dx.doi.org/10.1590/S0004-27302007000700003

Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA. 2000;283(14):1829-36. http://dx.doi.org/10.1001/jama.283.14.1829

O'Connor GT, Caffo B, Newman AB, Quan SF, Rapoport DM, Redline S, et al. Prospective study of sleep-disordered breathing and hypertension: the Sleep Heart Health Study. Am J Respir Crit Care Med. 2009;179(12):1159-64. http://dx.doi.org/10.1164/rccm.200712-1809OC

Cintra FD, Tufik S, Paola A, Feres MC, Melo-Fujita L, Oliveira W, et al. Perfil cardiovascular em pacientes com apneia obstrutiva do sono. Arq Bras Cardiol. 2011;96(4):293-9. http://dx.doi.org/10.1590/S0066-782X2011005000030

Dincer HE, O'Neill W. Deleterious effects of sleep-disordered breathing on the heart and vascular system. Respiration. 2006;73(1):124-30. http://dx.doi.org/10.1159/000089814

Lévy P, Pépin JL, Arnaud C, Baguet JP, Dematteis M, Mach F. Obstructive sleep apnea and atherosclerosis. Prog Cardiovasc Dis. 2009;51(5):400-10. http://dx.doi.org/10.1016/j.pcad.2008.03.001

Primi R. Inteligência fluida: definição fatorial, cognitiva e neuropsicológica. Paideia. 2002;12(23):57-75.

Petersen RC. Clinical practice. Mild cognitive impairment. N Engl J Med. 2011;364(23):2227-34. http://dx.doi.org/10.1056/NEJMcp0910237

Torelli F, Moscufo N, Garreffa G, Placidi F, Romigi A, Zannino S, et al. Cognitive profile and brain morphological changes in obstructive sleep apnea. Neuroimage. 2011;54(2):787-93. http://dx.doi.org/10.1016/j.neuroimage.2010.09.065

Beebe DW, Groesz L, Wells C, Nichols A, McGee K. The neuropsychological effects of obstructive sleep apnea: a metaanalysis of norm-referenced and case-controlled data. Sleep. 2003;26(3):298-307.

Marshall L, Born J. The contribution of sleep to hippocampusdependent memory consolidation. Trends Cogn Sci. 2007;11(10): 442-50. http://dx.doi.org/10.1016/j.tics.2007.09.001

Viegas CA, de Oliveira HW. Prevalence of risk factors for obstructive sleep apnea syndrome in interstate bus drivers. J Bras Pneumol. 2006;32(2):144-9.

Rodenstein D. Sleep apnea: traffic and occupational accidents –individual risks, socioeconomic and legal implications. Respiration. 2009;78(3):241-8. http://dx.doi.org/10.1159/000222811

Terán-Santos J, Jiménez-Gómez A, Cordero-Guevara J. The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med. 1999;340(11):847-51. http://dx.doi.org/10.1056/NEJM199903183401104

Tippin J, Sparks J, Rizzo M. Visual vigilance in drivers with obstructive sleep apnea. J Psychosom Res. 2009;67(2):143-51. http://dx.doi.org/10.1016/j.jpsychores.2009.03.015

Lemos LC, Marqueze EC, Sachi F, Lorenzi-Filho G, Moreno CR. Síndrome da apneia obstrutiva do sono em motoristas de caminhão. J Bras Pneumol. 2009;35(6):500-6.

de Mello MT, Bittencourt LR, Cunha Rde C, Esteves AM, Tufik S. Sleep and transit in Brasil: New Legislation. J Clin Sleep Med. 2009; 5(2):164-6.

Alonderis A, Barbé F, Bonsignore M, Calverley P, De Backer W, Diefenbach K, et al. Medico-legal implications of sleep apnoea syndrome: driving license regulations in Europe. Sleep Med. 2008;9(4):362-75. http://dx.doi.org/10.1016/j.sleep.2007.05.008

Rodenstein D. Driving in Europe: the need of a common policy for drivers with obstructive sleep apnoea syndrome. J Sleep Res. 2008;17(3):281-4. http://dx.doi.org/10.1111/j.1365-2869.2008.00669.x

Pandi-Perumal SR, Verster JC, Kayumov L, Lowe AD, Santana MG, Pires ML, et al. Sleep disorders, sleepiness and traffic safety: a public health menace. Braz J Med Biol Res. 2006;39(7):863-71. http://dx.doi.org/10.1590/S0100-879X2006000700003

Martinez D, Foppa M, Silva GC, Canais AA, Caramori C, Caleffi L. Sintomas respiratórios associados a distúrbios do sono em trabalhadores industriais no Rio Grande do Sul. J Pneumol. 1994;20(3):127-32.

Mitler MM, Carskadon MA, Czeisler CA, Dement WC, Dinges DF, Graeber RC. Catastrophes, sleep, and public policy: consensus report. Sleep. 1988;11(1):100-9.

Krishnan V, Shaman Z. Legal issues encountered when treating the patient with a sleep disorder. Chest. 2011;139(1):200-7. http://dx.doi.org/10.1378/chest.09-1962

Ellen RL, Marshall SC, Palayew M, Molnar FJ, Wilson KG, Man-Son-Hing M. Systematic review of motor vehicle crash risk in persons with sleep apnea. J Clin Sleep Med. 2006;2(2):193-200.